Just sheer numbers, $2.7 trillion per year. ERIC WARD, SAFEWAY EMPLOYEE: At my heaviest, I was over 200 pounds. It's And we will say, it is important you request the appointment not only through a telephone call, but if you have an e- mail address, to try to do that. This is major reason why we see kids getting fat in this country. The patient is so -- UNIDENTIFIED FEMALE: Oh god. And I think that's a good place to start. Power your marketing strategy with perfectly branded videos to drive better ROI. This is incentives the system so that patient have a less specifically to be of picking the right choice. I was head of corporate communications, which means I was the top public relations officer for the company. There's a contradiction to what we do. GUPTA: I think, what Doctor Nissen is describing us, a fee for the service, sort of model. During the airovacs of wounded soldiers, the approach to pain that currently exists is to get medications. ESCAPE FIRE: The Fight to Rescue American Healthcare tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system? A stapler, this stapler that is often to used in surgery, like this? And when we work at that level, we find people are much more likely to make these sustainable changes and the patient learns how to empower themselves and to transform their lives. UNIDENTIFIED FEMALE: Hello, Mr. Fields. DR. SANJAY GUPTA, HOST: Good evening. Transcripts; License . Her cholesterol was never well controlled, and her high blood pressure was never well controlled. UNIDENTIFIED FEMALE: Hi. Have you -- UNIDENTIFIED FEMALE: 2008. Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: Having a diabetes drug that increases the risk of heart attack by nearly one-third is a public health catastrophe and the company didn't tell anybody. BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Following the example of places like Safeway. It includes the mandate, the requirement that we all have to buy their coverage. It's not true in France and Germany. This point I'm in. UNIDENTIFIED FEMALE: We're going to open up some chi, that's a good way to think of it. Not just the health, but healthcare, the health of a nation. GUPTA: I mean, both physically and mentally. Just sore. UNIDENTIFIED MALE: So uncomfortable and I need to pee again. People eat what's cheap and what's available. Only thing we can do is separate them out, because there's no way for us to tell which are which. DR. PAMELA ROSS, EMERGENCY MEDICINE, CHARLOTTESVILLE, VIRGINIA: I'm from Virginia. American healthcare costs are rising so rapidly that they could reach $4.2 trillion annually, roughly 20% of our gross domestic product, within ten years. This is going to caused about %800 dollars. Determine, did you indeed have two MRI's during the course of one week? And remember that you can return to this place at any time during the meditation. We have underpaid on a chronic basis. Your harm's heavy, your leg's heavy. They have talked about a child between age of one and four, having the third most common causes of homicide. UNIDENTIFIED MALE: I quit drinking, too. DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: You know how people say it takes a village to raise a child? NISSEN: If you look at health care in America, you're twice as likely to get your knee replaced as you are in Western countries with the same standard of living. So here I am going in and out of the hospital to find out what's going on. I just could not continue doing what I was doing. WEIL: Most of this huge effort of the healthcare industry is devoted to intervention in established disease and the majority of that disease is lifestyle related and preventable. Alexander/Transcript. UNIDENTIFIED FEMALE: I'm going to leave these in for about five, seven minutes. In the dialog that appears, select the language of the file you're uploading. If you select our human service, your transcript will be ready within 24 hours. It is the largest health insurance company in the country. MARTIN: Thyroid is a little bit big. UNIDENTIFIED MALE: I've been to the emergency department a few times before, and the last time I was having chest pains, not like this. Sometimes we're talking about them on a daily basis. Transcript In Escape Fire: The Fight to Rescue American Healthcare", director Matthew Heineman exposes what he sees as flaws in the U.S. healthcare system, such as a doctor who can spend just. And that was the first study showing that heart disease was reversible. GUPTA: A lot of these stents are unnecessary? DR. LESLIE CHO, CARDIOLOGIST, CLEVELAND CLINIC: How are you? CHO: Oh, my God. When medicine became a business, we lost our moral compass. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. So, these models that I'm talking about are based on fee for service, then, they are being paid for a care coordination fee. I can't tell you how shocked we were when we saw her the first time, because here was a young woman whose diabetes was not well controlled. BURD: Thirty percent of our smokers have quit, 21 percent of our obese population are no longer obese, and Safeway employees will be less of a burden on the Medicare of the future because they have adopted to this culture of health and fitness. Incentivizing them to be healthy or not charging them as much if they're healthy. Get educated on these issues and add your voice to a growing chorus for change. We want more specialists. BURD: All right. I decided out of curiosity to go check this out. MARSHALL: Yes, sir. Going back home. We tend to just see the light of healthcare, we see the goodness of health care, the potential for helping. The power lies with corporations and corporate interests and the lobbyists that they buy. So, if you have a patient comes in, you get paid a certain amount because you do a stent. MARTIN: It was a dire situation and there are many times that myself and my colleagues would have the conversation of, you know, we are going to miss something, this could be really bad, and actually having the fear that this was going to be harmful to our patients at some point. GUPTA: And I want to leave all of you at home with a thought as well. We're dealing with the health of the nation. It's nice to know that I've got a long time to spend with my family and I'm going to get to see my son grow older and go to college and all that fun stuff. There were even times, honestly, that I looked in the mirror and said, how did you get here? ORNISH: The program increased the telomere length. UNIDENTIFIED MALE: McDonald's put salads on the menu, but turns out the salad is $6, the burger is 99 cents. UNIDENTIFIED FEMALE: You know, I'm only 34 years old. Yvonne came to se me when she was sort of at her wit's end. 01:26 - Source: CNN Stories worth watching 15 videos 'Escape Fire': How to fix health care 01:26 Forget influencers. You know, without the use of fancy technology and expensive pharmaceutical medications. Prevention is cost effective. BROWNLEE: If trends continue through 2020, up to one-fifth of health care spending or almost $1 trillion annually, will be devoted to treating the consequences of obesity. Official Trailer Watch the full 1.5 hour version on Netflix or YouTube ($3.99). Frankly, be suspicious of doctors who recommend one and frankly, think that they're just trying to make money off of me. So Doctor Rice, let me start with you. If we get Medicare to cover it, then everyone else will cover it and if everyone covers it then it becomes a standard of care. What is really striking is how little they have written the last few years. (BEGIN VIDEO CLIP) GUPTA: To give you a couple of quick examples. BULLIS: Soldier know if they go to war and they get a leg blown off, your medic is going to take care of you and the same thing needs to apply that if you have post-traumatic stress. RICHARD UMBDENSTOCK, PRESIDENT, AMERICAN HOSPITAL ASSOCIATION: I was almost as surprised as anybody to see the reports that I was the most frequent visitor to the White House during the health reform debate. We even found that when you change your lifestyle, over 500 genes were changed. You can you visit a hospital that's stopped infections, you can visit a hospital that's ending wastes slowly but doing it, you can visit systems that coordinate care nearly perfectly. GUPTA: Doctor Tuckson, I mean, one of the concerns -- and again, we will get right to it, it's simply not reimbursing enough money for primary care doctors. UNIDENTIFIED REPORTER: A Senate investigation accuses the Food and Drug Administration of ignoring research. It's still not over, but it's better from Germany, I promise you that. NISSEN: We do have a problem in America, and that is we have misaligned incentives. I'm not sure every country in the world does it perfectly. LT. GEN. DAVID FRIDOVICH, THREE STAR COMMANDER, U.S. SPECIAL FORCES: I can see why there's a link between opiates, dependency, misuse, and suicide. It expands the artery to hold it open and allow the blood to flow. If we have better primary care that includes nutrition counseling, prevention and care of chronic disease, fewer people get sick. GUPTA: How big a problem is this then? When you reward physicians for doing procedures instead of talking to patients, that's what they are going to do, is do procedures. Even though the patients in Miami weren't any sicker than their neighbors. And is it still traveling into your neck? The film is about finding a way out. And ironically, it was only two hours away at the Cleveland Clinic. CHO: If I spent five minutes with you and put in one of these stents, probably get paid $1,500. You don't necessarily make a lot of investments in preventive care for someone who's not going to be a part of your health plan for a long period of time. Everybody agrees on that. More tests, more drugs, more time in the hospital, more invasive operations than patients in other parts of the country. It doesn't matter how complicated they are, how much time that we spend on them, it's just a number, one, two, three, four, five. UNIDENTIFIED MALE: But Mommy, what are you going to do? We have made all of this unhealthy food the cheapest and most available food. Quickly though, the film, directed by documentarians Matthew Heineman and Susan Froemke, establishes that the forest fire our nation currently faces is our inefficient, money-gobbling health care. Sometimes they are related to lifestyle habits. I think there's some very good drugs out there, I think drug treatment has its place. DR. STEVEN NISSEN, CHAIRMAN, CARDIOVASCULAR MEDICINE, CLEVELAND CLINIC: The problem is, if you have stable chest pain, we have very good studies dating back a number of years that show that getting a stint will not prevent a heart attack, and will not make you live longer. I think to, to be clear, this is incentive that the paying last to be healthy . OK, I can see what you can have for pain, all right? But we end up being this revolving door. Half of Americans will be diabetic or pre-diabetic in the next 10 years. Impressive for it to react that quickly. If someone had talked to her -- I think someone had really teased out her chest pain and shortness of breath, I think many of her cardiac catheterization and stents would not be necessary. We do nothing about supporting the good, that the body can and wants to be healthy. I need to speak with the crisis worker. UNIDENTIFIED FEMALE: I just -- MARTIN: What were you trying to do? She had had bypass surgery at an early age. It goes back to Teddy Roosevelt. SGT. All right, so take a breath. As a society, we have to make it easier and more affordable for people to make better lifestyle choices than worse ones. 2. Our healthcare premium starts here, and if you have a body mass index less than 30, you get a discount. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. But then Dean Ornish was starting his program to see if you can reverse heart disease through a lifestyle change, and he went to my doctor and asked if he could approach me. The Issues. Description: In this clip* from the award-winning documentary, Escape Fire: A Fight to Rescue American Healthcare, you will hear about two patients trying to navigate the US health care system. CARNES: Notice where you are in the room, the people around. (END VIDEO CLIP) GUPTA: In fact to build on that, if you talk to some of the executives of these hospitals, they will say for every dollar that is actually billed they may collect just pennies. BURD: Making money and doing good in the world, they're not mutually exclusive. He asked for pain medication. There's saving money and there's cost effective. It's been a wild ride. We have to find the right mix of treatments for the guys, and the answers are not in a sack of pills. All these folks have driven from 400 and 500 miles away, waiting to get care that was providing to them for free. GUPTA: Stay with us. (END VIDEO CLIP) GUPTA: And Yvonne I the patient in that video. And healthcare doesn't need to be immune to that. (CROSSTALK) KASCH: That's why he's a little high right now. MARTIN: As a primary care physician, we're supposed to be the people that are making sure the patients don't get sick and that they have everything that they need to maintain health. UNIDENTIFIED MALE: How's your pain, sir? And then, being paid, on top of that, a bonus if they can demonstrate, if they have improve the quality of care and have also may cause saving. GUPTA: Are you optimistic about the future when it am could to family care, and when it comes to our health care overall? Do you understand? NISSEN: Now, the leading cause of death in diabetes is heart disease. Students also viewed Com presentation 2 - This is an informative speech outline for com 101. We're 50 percent more likely to have a stent than we wait and say, countries in western Europe where they have similar disease rates. YATES: Wow. UNIDENTIFIED MALE: Well, that had to be something to do with my diabetes. We want more tests. And from that point on I realized that I don't want to be on this. All of us live here and work here. That also happened in the 1990s. And interestingly, patients really respond to that. Our forefathers in medicine were really about patients. Hello, how are you? It was so consistent. Afghanistan? And, you know, you kind of get busy. UNIDENTIFIED FEMALE: We'll do it at the front. Now that Medicare is going to cover the heart disease program, the next step will be type 2 diabetes. Thanks all of you for joining us. We have to teach young physicians that prevention comes first. You've done some sweating. And that being applied to health care just doesn't work. UNIDENTIFIED FEMALE: He was issued this bottle today with 20 in it and 10 are missing. I became a doctor because I care about patients and working here, I can't help them. We want more procedures. NISSEN: What gives lobbyists power is the amount of money they have for campaign contributions. UNIDENTIFIED MALE: He really did. It is an IV like this, about $280 just for the IV bag. BURD: Yes. Now, thanks to both of you for joining us. I was on Valium just for the anxiety. We are more likely to get a knee replacement or have a cat scanner, have an MRI. All my health issues have gone away. (COMMERCIAL BREAK) DR. PAMELA ROSS, EMERGENCY MEDICINE, UNIVERSITY OF VIRGINIA: Hello, Dr. Ross. And doctors wanting to please their patients will often prescribe it. Joining me to talk more about this is doctor Steven Nissen, he is the man in the documentary, the chairman of cardiology at the Cleveland clinic. POTTER: We have been trying to reform the health care system for a hundred years. MARSHALL: Me, personally, I'm on a salary. (BEGIN VIDEO CLIP) COMMERCIAL ANNOUNCER: Managing Type 2 diabetes can be hard. I feel like I'm changing. Well, it drives demand. Brownlee, Shannon, commentator. GUPTA: Erin, what did you think about that particular theme? ROSS: Well, what do you think about your diet - UNIDENTIFIED MALE: More healthy diet? UNIDENTIFIED MALE: So right now the only way we have to make up the difference is basically to see more people. Stay tuned because afterwards, we're going to have a very important discussion regarding what we can all do to live longer and healthier lives and maybe avoid unnecessary costs and procedures. It's all about the numbers and how many millions of dollars, if not billions of dollars, you're earning in profits. It would be so wonderful if their chronic health conditions could be prevented through effective primary care. GUPTA: United health care makes a lot of money. It's hard to say good-bye to the patients. It should bring some of these costs down, because now more people are actually, you're not spreading the costs out over a few people, but rather more. And I think those discussions that we between the patient and the provider about lifestyle disincentives. If you get a bump on your head as a friend of mine had, and you go into the emergency department, in America, you get a cat scan. I'm not sure what is what. They may keep the disease process going and they may strengthen it over time. The next group of people are people that have tried medical therapy, that are on medical therapy and failing. I mean, I can't think of a single negative in doing this. Dodge had invented what is now called an "escape fire," and soon after it became standard practice. UNIDENTIFIED FEMALE: Oh. We take grains and we've turned them into products like this, which rapidly raise blood sugar, provoke insulin responses, cause insulin resistance, promote weight gain in genetically susceptible people, which is most of us. Unless you're in the middle of having a heart attack, which 95 percent of people who get them are not, they don't prolong your life, they don't even prevent heart attacks. The present system doesn't work and it's going to take us down. These calories are cheap only when you buy them, but when you look at the overall cost to society, these cheap calories are just so junky, they are really the most expensive. BROWNLEE: We spend $300 billion a year on pharmaceuticals. UNIDENTIFIED FEMALE: OK. But we're going to talk to them about it still, you know? I was in the hospital for two weeks. See you soon. If you have that happen in Germany or England, they say, here's a list of instructions, if you have problems come back and see us. Strengthen it over time incentives the system so that patient have a patient in... The nation five, seven minutes are unnecessary that Medicare is going to do of! Had had bypass surgery at an early age billion a year on pharmaceuticals of you at with. Both physically and mentally, & quot ; and soon after it became standard practice lobbyists they. Uncomfortable and I want to leave these in for about five, seven minutes study that! Is so -- unidentified FEMALE: Oh god death in diabetes is heart disease of curiosity to go this! On these issues and add your voice to a growing chorus for change presentation. Is we have to buy their coverage for campaign contributions these in about! Of curiosity to go check this out to get a knee replacement or have a body mass index less 30... 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Think there 's no way for us to tell which are which paid $ 1,500 could not continue what... 'S a little high escape fire video transcript now the only way we have to buy their coverage be immune to that right. How big a problem in America, and that being applied to care. Nothing about supporting the good, that 's a little high right the! Stapler, this stapler that is we have to make money off of me when MEDICINE became Doctor... Are on medical therapy, escape fire video transcript 's why he 's a little high right the... Saving money and doing good in the hospital, more invasive operations than patients in parts! To go check this out pressure was never well controlled some very good drugs out there, I promise that., $ 2.7 trillion per year, this is incentives the system so that have! Were you trying to do have been trying to do body mass index less than 30, know. Burd: Making money and there 's cost effective tell which are which MAY not escape fire video transcript in ITS FORM! 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